| New Leaf Nutrition, Pllc | |
|
636 Sw 152nd St Suite D Burien WA 98166-2264 | |
| (206) 383-7704 | |
| (206) 274-4810 |
| Full Name | New Leaf Nutrition, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 636 Sw 152nd St, Burien, Washington |
| Authorized Official Name and Position | Danielle Venhuizen (OWNER) |
| Authorized Official Contact | 2066188245 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Leaf Nutrition, Pllc 3809 Sw Graham St Seattle WA 98126-3035 Ph: (206) 618-8245 | New Leaf Nutrition, Pllc 636 Sw 152nd St Suite D Burien WA 98166-2264 Ph: (206) 383-7704 |
| NPI Number | 1902132160 |
|---|---|
| Provider Enumeration Date | 10/23/2009 |
| Last Update Date | 12/29/2010 |
| Medicare PECOS PAC ID | 5092854273 |
|---|---|
| Medicare Enrollment ID | O20091201000290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902132160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DI00002075 (Washington) | Primary |
| Provider Name | Danielle Venhuizen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1336317056 PECOS PAC ID: 0749329928 Enrollment ID: I20091201000279 |
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